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PRAXES Sales Discovery Form

Thank you for your interest in our services!

The information collected in this form will allow us to assess your requirements, confirm our ability to meet them, and prepare a tailored quote with clear next steps.

If you have any questions, please get in touch with sales@praxes.ca.

Please enable JavaScript in your browser to complete this form.

Email: *

Services Required? *

24/7/365 Telemedicine/Topside Assistance
Medical Kit (Medication/Equipment)
Medical Chest Inspection
Medical Staffing
Stand-Alone PRAXES Connect Integration (Electronic Medical Record)

24/7/365 Telemedicine/Topside Assistance

Interested Service Plan? *

Core
Premium: includes PRAXES Connect
Elite: includes PRAXES Connect Elite Package
Unsure

Click Here to View our Service Plans

Length of Service Required? *

Planned Service Start Date? *

Please Note: Services can typically begin within 4 days after client onboarding is complete, unless a later start date is requested.

Planned Service End Date (if known)?

Please list each Location / Worksite / Vessel requiring coverage, and the maximum number of people on-site / on-board. Click “+” to add more.

(Includes staff, crew, guests, visitors, passengers, etc.)

please Date Service

Location / Worksite / Vessel

Location / Worksite / Vessel Name:

Maximum # of People On-Site / On-Board:

Service Language Requirements? *

English
French & English

Do your locations / worksites / vessels have the ability to place phone calls with stable connectivity? *

Yes
No

The ability to place stable connectivity phone calls is essential for our Telemedicine services. Please contact sales@praxes.ca for more information.

Planned Method for Calling PRAXES? *

Satellite Phone
Mobile Phone
VOIP Phone
Landline
Wifi Calling
Other

This helps our technical support team understand what technology will be used, to help support any phone connection issues. Note: WhatsApp Calling is Not Supported.

If Other, please specify:

Medical Role, Training, or Certification Level of Primary Telemedicine Caller? *

No Medical Training
Basic First Aid / CPR
EMR (Emergency Medical Responder)
PCP (Primary Care Paramedic)
ACP (Advanced Care Paramedic)
Nurse (e.g., RN, LPN)
Physician
Other

If Other, please specify:

Do you require a PRAXES Certificate for Proof of Telemedicine coverage? *

Yes
No

Do you have an existing medical kit onsite? *

Yes
No

An On-Site Medical Kit at each location / worksite / vessel is essential for our Telemedicine services so that our PRAXES Doctors know what they can recommend and prescribe. Contact sales@praxes.ca for more information.

Medical Kit (Medication/Equipment)

What type of Medical Kit do you require? *

If Other, please specify:

Medical Kit Selection? *

New Kit
Resupply

What type of Medical Kit is onsite? *

If Other, please specify:

Do you require an Annual Medical Kit Certification of Compliance?

Yes
No

Medical Kit / Equipment Shipping Location? *

Within Canada
Outside of Canada

Country: *

Medical Chest Inspection

Average number of crew onboard? *

Type of Certification of Compliance Required? *

If Other, please specify:

Vessel Flag?

Date Required? *

Location of Vessel: *

Address Line 1

City

State / Province / Region

Country

Medical Staffing

Event Type?

If Other, please specify:

How many people will be attending the event? *

Event Start Date & Time? *

Date

Time

Event End Date & Time? *

Date

Time

Address of Event

Address Line 1

City

State / Province / Region

Country

Stand-Alone PRAXES Connect Integration (Electronic Medical Record)

Number of Planned Users? *

Number of Locations/Worksites/Vessels Requiring Access? *

Please Specify:

Length of Service Required? *

Planned Service Start Date? *

Please Note: Services can typically begin within 4 days after onboarding is complete, unless a later start date is requested.

Interested Service Plan(s)? *

Base Bundle
Telemedicine + Client Branded Server Bundle
Medication Management Bundle
QA Panel Bundle
Workflow Bundle
Case Referral Feature
Online Intake Form Feature
Unsure

Click Here to View our PRAXES Connect Bundles & Features

PRAXES Medical Group

PRAXES Medical Group delivers expert 24/7 telemedicine services. Powered by PRAXES Connect, we ensure reliable, efficient, and professional medical support for businesses and individuals worldwide.

Useful links

Contact Us

sales@praxes.ca

+1 902-420-9725

5539 Young St Suite B, Halifax, NS B3K 1Z7

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